OUT: BLOOD BANKING. IN: STOOL-BANKING:
By last August, my 1-year-old son had taken five courses of antibiotics for recurrent ear infections. That was alarming. By age 10, the average American child has had about 10 courses, and some microbiologists argue that even one course a year is too many — that it might damage our native microbial ecosystem, with far-reaching consequences.
My son was off to a worrisome start. Why, I wondered, didn’t doctors work harder to prevent this collateral damage, not with store-bought probiotics, but with “microbial restoration”? Why didn’t we reinfuse patients with their own microbes after antibiotics?
The scientific term for this is “autologous fecal transplant.” In theory, it could work like a system reboot disk works for your computer. You’d freeze your feces, which are roughly half microbes, and when your microbiome became corrupted or was depleted with antimicrobials, you could “reinstall” it from a backup copy. . . .
The “self-transplant” isn’t a new idea. In the late 1950s, a medical technologist named Stanley Falkow practiced what he called “fecal reconstitution.” Gut troubles often plagued surgery patients during recovery. They’d received antibiotics prophylactically, depleting their native gut microbes. So Mr. Falkow, working with an internist, began giving these patients capsules containing their own feces, collected and frozen before treatment. It helped tremendously. But when the hospital administrator found out — patients didn’t know what they were swallowing — he fired Mr. Falkow. (Mr. Falkow, now Dr. Falkow, an emeritus microbiology professor at Stanford, was rehired soon thereafter, but had to abandon the project.)
Almost 60 years later, the “fecal transplant” is a cutting-edge treatment for the pathogen Clostridium difficile, a bug that kills 29,000 yearly and infects nearly half a million. “C. diff” tends to strike after antibiotics deplete the microbes that naturally inhabit the gut, leaving us vulnerable to invasion. So far, fecal transplants seem to be more than 90 percent effective at curing these infections.
As currently practiced, however, the transplant material usually comes from someone else. Even with careful screening, that presents some risk. It’s theoretically safer to receive one’s own microbes.
The 21st century isn’t turning out as I’d expected. That said, this seems like a good idea, and one that’s been shamefully ignored (or suppressed) because of people’s childish “yuck” reactions.